Children who fail vision screenings while wearing spectacles often have an outdated prescription, a study shows. Also, they have more severe refractive errors than those who do not wear glasses, according to the findings published in Ophthalmic Epidemiology.

Researchers conducted a study to compare the vision needs of children wearing and not wearing eyeglasses who failed a school-based vision screening. Participants were between 4 and 16 years of age and attended 41 Baltimore City schools using distance visual acuity (VA) and photoscreening. Students who failed the screening underwent a school-based noncycloplegic examination, and the students wearing eyeglasses at screening were compared with those not wearing eyeglasses with respect to age, sex, right-eye refractive error, right-eye presenting, and best-corrected VA.

The study found that 2176 students failed the screening and completed the examination. Of these, 4.3% (n = 94) were wearing eyeglasses during screening, and most were older (mean age 10.2 vs 8.8 years, P <.001). In students wearing eyeglasses, myopia (P <.001), astigmatism (P =.004), and severe astigmatism (>3.0 D of cylinder, P =.008) were more common. For students wearing eyeglasses at failed screening, the prescription rate was higher (95.7% vs 80.4%, P <.001) than for those not wearing eyeglasses. Finally, a small number of children in both groups (approximately 4.0%, P =.6) required referral to community providers for nonrefractive pathology.


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The study explains that, according to past research, there is a reduced level of accuracy of vision screening in children due to an assumption that those wearing eyeglasses have good vision. However, the researchers show in the present study that this is not necessarily the case.

“We found that those who were wearing eyeglasses who failed screening and attended a definitive eye examination had reduced acuity at the same level as students who failed screening without eyeglasses,” the study notes.

Additionally, the researchers point out their finding that myopia and astigmatism were more common and severe for students who were wearing eyeglasses at the time of screening, compared with those who were not. 

The study notes the limitation that it was unable to calculate screening failure rates among all eyeglasses wearers and non-wearers due to only having screening and examination data for students who failed the screening and provided consent for research.

Disclosure: One of the study authors declared affiliations with the biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.

Reference

Shakarchi A, Guo X, Friedman D, Repka M, Collins M. Vision needs of children who failed school-based vision screening with and without eyeglasses. Ophthalmic Epidemiol.  2021;28(2):131-137. doi:10.1080/09286586.2020.1800754